Scoping review identifies factors taxing physicians’ attention

Scoping review identifies factors taxing physicians’ attention

Abstract: https://www.acpjournals.org/doi/10.7326/M23-3229  

Editorial: https://www.acpjournals.org/doi/10.7326/M24-0880  

URL goes live when the embargo lifts     

Researchers from the University of Colorado Anschutz Medical Campus systematically reviewed 6,448 studies to identify and characterize the literature on clinician attention, compile the metrics used to measure attention, and create a framework of key concepts related to clinician attention. The findings are published in Annals of Internal Medicine.

The authors defined attention as a state of presence, focus, and selective incorporation of information within clinical environments. The concept of an “ecology of attention” was used to describe an analogous interrelationship between clinician attention and the clinical environment, suggesting key measurable factors that influence the ability of clinicians to maintain presence and focus. Of the studies reviewed, 585 met inclusion criteria. About 80% were descriptive, and 20% were investigational. More studies (66%) focused on barriers to clinician attention than on facilitators of attention. A 6-category framework was derived to organize the literature that included definitions of attention; evaluation of the clinical environment’s effect on attention; personal factors affecting attention; relationships between interventions and factors that affect attention and patient outcomes; the effect of clinical alarms and alarm fatigue on attention; and the effect of health information technology on attention. The authors believe the findings from their scoping review and the analytic framework will help researchers or quality improvement experts studying or looking to improve the “ecology of attention.”

The authors of an accompanying editorial from Stanford University School of Medicine say that clinician attention should be spent in the right places. Incremental initiatives intended to enhance safety may not work if they overwhelm working memory and take attention away from other important activities, especially considering that the complexity of daily work for most health care professionals now exceeds human beings’ finite cognitive load capacity. The authors suggest that adoption of human factors and ergonomics principles can help the health care delivery system address this issue and enable the provision of high-quality, compassionate, and cost-effective care in a sustainable manner.

Media contacts: For an embargoed PDF, please contact Angela Collom at [email protected]. To speak with the corresponding author, please contact Kelsey Hussey at [email protected].